title: The effect of hypertension on aortic pulse wave velocity in type-1 diabetes mellitus patients: assessment with MRI.
abstract: To investigate in type-1 diabetes mellitus (DM1) patients the role of hypertension and of DM1 itself on aortic stiffness by using magnetic resonance imaging (MRI). Consecutive patients from the diabetes and hypertension outpatient clinic and healthy volunteers were included in our study. Subjects were divided into four groups: 32 healthy volunteers (mean age: 54.5 ± 6.8 years), 20 DM1 patients (mean age: 48.3 ± 5.9 years), 31 hypertensive patients (mean age: 59.9 ± 7.2 years) and 28 patients with both DM1 and hypertension (mean age: 50.1 ± 6.2 years). Aortic stiffness was measured by means of pulse wave velocity (PWV) using velocity-encoded MRI. Analysis of variance (ANOVA), uni- and multivariable regression models and the Bonferroni-test for multiple testing, were used for statistical analyses. Mean aortic PWV was 5.7 ± 1.2 m/s in healthy volunteers, 5.9 ± 1.2 m/s in DM1 patients without hypertension, 7.3 ± 1.2 m/s in hypertensive patients and 7.3 ± 1.3 m/s in patients with both DM1 and hypertension. Compared to healthy control subjects, aortic PWV was significantly higher in patients with hypertension (P < 0.001) and in patients with both DM1 and hypertension (P < 0.001), whereas aortic PWV was not increased in patients having DM1 alone. Furthermore, aortic PWV was significantly higher in DM1 patients with hypertension than in patients with DM1 alone (P = 0.002). These findings remained after adjustment for confounding factors. Hypertension has a predominant contributive effect on aortic stiffness in DM1 patients whereas the direct diabetic effect on aortic stiffness is small.
authors.affiliation: Department of Radiology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands. a.brandts@lumc.nl
authors.forename: A
authors.initials: A
authors.lastname: Brandts
authors.forename: S G C
authors.initials: SG
authors.lastname: van Elderen
authors.forename: J T
authors.initials: JT
authors.lastname: Tamsma
authors.forename: J W A
authors.initials: JW
authors.lastname: Smit
authors.forename: L J M
authors.initials: LJ
authors.lastname: Kroft
authors.forename: H J
authors.initials: HJ
authors.lastname: Lamb
authors.forename: R W
authors.initials: RW
authors.lastname: van der Meer
authors.forename: J J M
authors.initials: JJ
authors.lastname: Westenberg
authors.forename: A
authors.initials: A
authors.lastname: de Roos
mesh_terms: D000328:Adult; D001011:Aorta / Q000503:physiopathology*; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D003187:Compliance; D003430:Cross-Sectional Studies; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D003925:Diabetic Angiopathies / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D011237:Predictive Value of Tests; D011673:Pulsatile Flow; D012044:Regression Analysis; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors